Early childhood caries (ECC) is a major health problem that has a disproportionate effect on minority and disadvantaged children. An underlying contributor to this problem is parental behaviors that appear to be inconsistent with good oral health literacy. The purpose of this study is to begin the process of developing and evaluating an oral health literacy instrument that can be used by primary medical care and oral health care providers to assess the degree to which parents/guardians have the capacity to obtain, process, and understand basic oral health information and services needed to make appropriate decisions that have a direct impact on the oral health of their preschool children. The development of an initial version of the oral health literacy assessment instrument will be in three phases. Phase I will consist of defining the construct of oral health literacy via a Delphi process conducted with 8-10 identified oral health experts. Phase II will consist of constructing a draft assessment instrument. Phase III will employ in-depth cognitive interviewing of 8-10 parents/guardians from each of four socio-culturally distinct population groups (African American, Appalachian, Hispanic/Latino, and white, non-Appalachian, non-Hispanic/Latino) to identify potential problems that might lead to survey response error. The instrument will then be pilot-tested in two pediatric safety-net facilities that have implemented a program of oral health screening and fluoride varnish application for preschool children. Approximately 300 parents/guardians of children 0-5 years of age who provide informed consent will be asked to complete the oral health literacy assessment instrument and four additional brief surveys. Data from these surveys as well as data collected on the oral health status of children as part of the oral health screening/fluoride varnish program will be used in various psychometric analyses to assess the reliability and validity of the instrument. [unreadable] [unreadable]